The federal government has decimated Canada’s Federal Tobacco Control Strategy
(FTCS) by cutting $15 million from the national tobacco control budget. National
health organizations were informed of the news in a conference call with Health
Canada on April 11. Over the last six years, the government’s tobacco control
budget has dropped by $40 million, from $68 million in 2006 to $28 million for
the 2012 fiscal year.

The axe also fell on a $16 million grants and contributions program that used to
help fund 74 national and regional non-governmental organizations (NGOs). As a
result of the cuts, the federal government will now spend 0.9 per cent of the $3
billion in annual tax revenues it collects from tobacco sales on tobacco control
measures. Not only will the cuts impact NGOs throughout the country, but they
will directly affect Health Canada’s regulatory, enforcement, and research work
plans.

“Consider who wins by this decision: the only winner — and they are big winners
— is Big Tobacco,” said Garfield Mahood, founding executive director of the
Non-Smokers’ Rights Association (NSRA). “By slashing funding to health groups,
the Harper government has virtually assured that tobacco companies will have the
upper hand in influencing federal policy decisions.”

To put the budget cuts in perspective, the U.S. Centers for Disease Control
recommends government spending of $12 per capita to sustain a comprehensive
tobacco control program. With $28 million left to fund federal tobacco control
and a national population of 34.67 million according to the latest figures from
Statistics Canada, the FTCS money translates to $0.81 per capita.

The government’s decision to scale back funding by 35 per cent is even more
baffling when considered from a financial perspective. A press release issued by
the NSRA offers the following analysis of the tremendous return on investment
provided by the government’s 10-year FTCS:

“The Federal Tobacco Control Strategy was arguably the most successful health
initiative ever undertaken by the federal government — in terms of lives saved,
disease prevented, improvements to quality of life, health care cost savings,
and cost-effectiveness. Smoking rates among Canadians aged 15+ dropped from 24
per cent to 17 per cent between 2000 and 2010, representing 1.1 million fewer
smokers and more than half a million averted tobacco-caused deaths. Rates of
tobacco use among youth were cut in half during the life of the Strategy, a feat
achieved by few other countries. An analysis commissioned by Health Canada
concluded that one person quitting smoking results in an average savings of
$8,500 in avoided health care costs. This means that the federal government’s
investment of $500 million over the ten years of the Strategy is expected to
yield savings of $9.6 billion in direct health care expenditures alone — close
to a twenty-fold return on investment.”

Canada’s tobacco control act

Founded in 1974, the NSRA’s body of work over the past 38 years provides a
poignant example of how vital NGOs are in advancing progressive legislative
measures and monitoring tobacco industry activities.

In 1988, the NSRA’s forceful campaigning led to the Tobacco Products Control
Act, Canada’s first tobacco control act, which included a ban on tobacco
advertising and the right to impose health warnings on cigarette packs. And when
the Supreme Court overturned parts of the act in 1995, the NSRA was instrumental
in securing passage of the Tobacco Act, a reformed version of the initial
legislation.

The contraband crisis

In 1992, the NSRA began lobbying the federal government about Big Tobacco’s role
in an emerging cigarette smuggling problem. In January of 1998, the Canadian
Cancer Society, the Canadian Council for Tobacco Control, and the NSRA filed a
complaint with the RCMP, calling for a criminal investigation into the tobacco
industry’s role in the rampant smuggling problem. The RCMP launched an
investigation and produced a 172-page affidavit detailing the smuggling ring,
which included several co-conspirators and dated back to the early 1990s.

On November 26, 2004, the RCMP executed a three-day raid at the offices of
Imperial Tobacco Ltd. (ITL). Charges were filed against ITL and Rothmans, Benson
& Hedges (RBH). In 2008, rather than face the public scrutiny of a court case,
ITL and RBH pled guilty and struck a $1.15 billion settlement agreement with the
federal and provincial governments.

In a separate case, the federal government and several provincial governments
filed a $10 billion lawsuit against JTI-Macdonald and two U.S.-based companies,
R.J. Reynolds (RJR) and Northern Brands International, a subsidiary of RJR. In
2010, the three companies signed a $550 million settlement, bringing the total
settlement on the contraband conspiracy to $1.7 billion. This second agreement
was heavily criticized because the settlement amount was nearly twenty times
less than the original charges.

A collaborative effort between government and national health organizations also
led to the introduction of the world’s first graphic tobacco package warnings in
2000. Since then, according to a World Health Organization report, 41 countries
have followed suit. But without the research efforts and leadership of the
Canadian Cancer Society, Physicians for a Smoke-Free Canada, the NSRA, and the
support of regional NGOs from across Canada, Liberal Health Minister Allan Rock
would never have passed the pioneering legislation.

In short, the FTCS has been working because of a comprehensive and integrated
approach to tobacco control, involving policy makers, researchers, advocacy
groups, health organizations, and regional and local health units. And unlike
many other causes of disease, tobacco use generates huge sums of money that can
be used to fund effective public health programs.

Funding cut despite increased tax revenues

The federal government collects $3 billion a year in taxes from tobacco sales,
up from the $2.5 billion it received in 2009, due to decreased sales of
contraband tobacco.

So why would the Harper administration choose to cut funding year after year for
a program that has been so effective in reducing smoking prevalence, and
provides Canadian taxpayers with a twenty-fold return on their investment in
tobacco control initiatives?

On April 17, a press conference was held at the Parliamentary Press Gallery in
Ottawa to denounce the government’s cuts. Representatives from the Canadian
Cancer Society; the NSRA; the Canadian Dental Association; the Quebec Coalition
for Tobacco Control; and the Ottawa Heart Institute led the press conference.
Each of these NGOs issued press releases, as did the Heart and Stroke
Foundation; Physicians for a Smoke-Free Canada; the Canadian Council for Tobacco
Control; the Canadian Medical Association; the Canadian Dental Hygienists
Association; Smoke-Free Nova Scotia; and the Ontario Campaign for Action on
Tobacco.

Dr. Andrew Pipe, who deals with the realities of tobacco-related diseases in his
clinical practice as chief of the Division of Prevention and Rehabilitation at
the University of Ottawa Heart Institute, is baffled by the government’s lack of
imagination towards tobacco control:

“It is staggering to me that at a time when we recognize that the leading cause
of preventable disease, death, and disability in Canada is tobacco addiction,
our government is receding from its obligation to ensure we create a community
free from tobacco. It strikes me as sadly ironic that if we were to apply an
inflationary tax increase of $2 per carton of cigarettes, we would have more
than enough resources to continue Canada’s tobacco control program in its
present form. I am saddened that there seems to have been a complete lack of
imagination or insight on the part of those who have crafted this policy.”

What is perhaps most insulting to national and regional NGOs is that after
decades of fighting to make Canada a global model for tobacco control and to
reduce smoking prevalence, their success is being used as an excuse by the
federal government to slash funding and cut jobs. Furthermore, the government
has yet to offer any details on how it plans to spend the remaining tobacco
control dollars, leaving many tobacco control advocates to wonder whether Canada
has a federal strategy at all, since the FTCS expired on March 31, 2011, and no
new strategy document has been made public.

“So far, the only elements of the new FTCS are cuts in funding, mandate, and
scope — along with a few carefully crafted photo-ops,” remarked Flory Doucas,
co-director and spokesperson for the Quebec Coalition for Tobacco Control. “But
there is no forward-looking plan designed to counter a public health epidemic
driven by a vector as resilient and lethal as the tobacco industry’s products.”

Ottawa’s ‘refocused’ tobacco plan

In a press release regarding the funding cuts, Health Minister Leona Aglukkaq
defended the cuts, saying: “Canada is a world leader in tobacco control. Our
government is proud of the work it has done, and is now refocusing our
anti-smoking grants and contributions program towards populations with higher
smoking rates. In particular, aboriginal populations within Canada have rates as
high as 50 per cent.”

Shortly after the Conservatives took office in 2006, however, they ‘suspended’
$10 million in annual funding for the First Nations and Inuit Tobacco Control
Strategy, promising to reinstate the funding when a more effective strategy was
developed. Despite repeated inquiries from NGOs, no new strategy has been
issued.

In the 2012 budget, $5 million will be directed to tobacco control measures in
First Nations and Inuit communities. Although the government highlights this as
the main feature of its ‘refocused’ plan, it is still half of what used to be
invested in addressing the public health epidemic that exists in aboriginal
communities; and it does not address the other 93 per cent of Canadian smokers
who do not live on reserves.

Five million Canadians still smoke. One in six smokers will die prematurely,
while 50 per cent of all long-term smokers will die from smoking-related
diseases. Taxpayers shoulder an annual health care burden of $4.4 billion for
treating lung, throat, and mouth cancers; heart and cardiovascular disease;
chronic obstructive pulmonary disease; diabetes; blindness; and many other
smoking-related illnesses.

By decimating the FTCS over the past six years, the federal government has
assured Canadian taxpayers that the burden of paying the direct health costs of
diseases caused by tobacco will continue for a long time.